Nephrology Research Group, Queen's University, Belfast City Hospital, Belfast, Northern Ireland.
Am J Kidney Dis. 2013 Sep;62(3):604-14. doi: 10.1053/j.ajkd.2012.12.033. Epub 2013 Mar 13.
Activation of the complement pathway is implicated in the pathogenesis of many kidney diseases. The pathologic and clinical features of these diseases are determined in part by the mechanism and location of complement activation within the kidney parenchyma. This review describes the physiology, action, and control of the complement cascade and explains the role of complement overactivation and dysregulation in kidney disease. There have been recent advances in the understanding of the effects of upregulation of the complement cascade after kidney transplantation. Complement plays an important role in initiating and propagating damage to transplanted kidneys in ischemia-reperfusion injury, antibody-mediated rejection, and cell-mediated rejection. Complement-targeting therapies presently are in development, and the first direct complement medication for kidney disease was licensed in 2011. The potential therapeutic targets for anticomplement drugs in kidney disease are described. Clinical and experimental studies are ongoing to identify further roles for complement-targeting therapy.
补体途径的激活与许多肾脏疾病的发病机制有关。这些疾病的病理和临床特征部分取决于补体在肾脏实质中的激活机制和位置。本综述描述了补体级联的生理学、作用和控制，并解释了补体过度激活和失调在肾脏疾病中的作用。最近在理解肾移植后补体级联的上调的影响方面取得了进展。补体在缺血再灌注损伤、抗体介导的排斥反应和细胞介导的排斥反应中对移植肾脏的损伤的启动和传播中发挥重要作用。目前正在开发补体靶向治疗方法，并且 2011 年首次获得了用于肾脏疾病的直接补体药物的许可。描述了肾脏疾病中抗补体药物的潜在治疗靶点。正在进行临床和实验研究以确定补体靶向治疗的进一步作用。
